Fig. 1.

a Illustration of the Q^TM and stent retriever combined approach during the thrombus wedging maneuver. After removing the microcatheter, the stent retriever has been slightly retracted and the Q^TM catheter carefully advanced under pump aspiration to ensure better engagement of the thrombus. The flared proximal tip of the Q catheter (magnified inset) ensures a tight seal between its outer surface and the Super 90 guiding catheter’s inner surface, enabling increased suction power (curved black dashed arrow) directly through the guide catheter. b Anteroposterior left internal carotid artery (ICA) angiography through the Super 90 guiding catheter showing a terminal ICA occlusion. c Unsubtracted anteroposterior view showing the combined approach thrombectomy: Distal end of the Super 90 Catheter (white circle), distal end of a Q6 aspiration catheter (white arrow), and a fully deployed Aperio® Hybrid stent with its proximal end inside the Q6 (white arrowhead). d Q6 and Aperio® Hybrid with the “pinned” thrombus